1. Field of the Invention
The present invention relates generally to medical methods and apparatus. More particularly, the present invention relates to methods for locating and identifying surgical articles which have not been accounted for at the end of the surgical procedure.
Surgical sponges and other gauze articles are used to absorb blood and other body fluids during surgery. Many individual sponges can be used in a single procedure, and all the sponges which are used must be removed from the patient prior to closing an incision at the end of the procedure.
When used in a surgical procedure, sponges and other gauze articles become saturated with blood, alter in size and shape, and become difficult to visually distinguish from body tissue and from each other. Thus, while it might seem an easy task to locate and remove all sponges and other gauze articles from a patient at the end of surgery, the sponges are very hard to identify and difficult to count when they adhere to each other when soaked with blood. The task of accounting for sponges is even more difficult and more complex in surgical procedures where large numbers of sponges of many sizes and types may be used. Errors can occur when sponges are miscounted during initial counts and/or subsequent counts. When a subsequent count does not match a previous count, a recount is typically taken. Potentially more serious, a single sponge can mistakenly be counted more than once, raising the possibility a count can be incorrectly considered accurate allowing the patient to be closed with a sponge still at the operative site.
An improved method and system for accounting and identifying surgical sponges is described in U.S. Pat. No. 5,931,824, which is commonly assigned with the present application and which is incorporated herein by reference. As shown in FIGS. 1 and 2, which are taken from this patent, each sponge 10 used in a procedure is provided with a substrate or label 12 which includes machine-readable information 14, typically in the form of a bar code. If a total of N sponges are to be set aside for use in a procedure, each of the sponges 10, 10′, . . . 10N will have a label 12 with unique label identification provided by the machine-readable information 14. Thus, the sponges 10 or other surgical articles may be scanned using a hand-held or other scanner 20, and the identification information stored in a computer 22 or other digital microprocessor-based unit. By scanning the identification of all sponges or other articles 10 to be used prior to the procedure and then scanning all sponges 10 as they are being removed from the patient after the procedure (as well as any sponges which might not have been used), the computer 22 can compare a compilation of the original group of sponges with the group of removed and unused sponges to determine if any sponges are missing and unaccounted for. If a sponge is accidentally scanned more than once, the computer will recognize the error and only allow each individual sponge to be counted in once and out once.
If the system of the '824 patent determines that all sponges have been accounted for after sponge removal, then it will be certain that all sponges have indeed been removed and the patient is ready to be surgically closed. If, however, the system indicates that one or more sponges are missing, it is necessary for the nurses and surgeons to visually inspect the surgical site in an attempt to locate the missing sponge(s). If they cannot locate the sponge(s) in the surgical site, then they must recount and rescan the removed sponges which are bloodied and difficult to separate. It will be necessary to separate and rescan each individual sponge until the system scans the missing sponge(s), indicating that the count is complete. Such recounts can take significant time and effort, but must be undertaken perhaps multiple times until the count is complete.
For these reasons, it would be desirable to provide improved methods and systems for scanning machine-readable information on surgical sponges and other articles which are used in surgical procedures. It would be particularly advantageous if the methods and systems could provide information relating to the particular missing article(s) which would assist the surgical team in performing recounts and visually identifying the missing article(s). At least some of these objectives will be met by the inventions described and claimed hereinbelow.
2. Description of the Background Art
U.S. Pat. No. 5,931,824 has been discussed above. Other pertinent patents and published applications include U.S. Pat. Nos. 3,941,132; 3,965,907; 4,098,728; 4,114,601; 4,244,369; 4,264,575; 4,477,256; 4,626,251; 4,639,253; 4,645,499; 4,658,818; 4,711,996; 4,718,897; 4,832,198; 4,917,694; 5,031,642; 5,041,103; 5,045,080; 5,049,219; 5,057,095; 5,074,840; 5,112,325; 5,231,273; 5,374,813; 5,443,082; 5,456,718; 5,610,811; 5,629,498; 5,650,596; 5,637,850; 5,678,569; 5,805,451; 5,923,001; 5,991,728; U.S. Publ. 2002/0049650; WO 94/22580; WO 98/30166; and EP 0948940.